Women's obstetric and reproductive health care discourse in online forums: Perceived access and quality pre- and post-Affordable Care Act.

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ID: 49852
2019
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Abstract
This corpus-based study examines women's framing of health issues in online forums (MedHelp.org, AphroditeWomensHealth.com, and Connect.MayoClinic.org) prior to, during, and after implementation of the Affordable Care Act (ACA). Since worldviews affect how women describe health issues, their discourse is both a way to see ideology indexed in the forums, as well as how that discourse has been shaped by policy. Posts were collected December 2016-April 2017 and annotated using the UAM (Universidad Autónoma de Madrid) Corpus Tool to examine emergent categories and compare them to three time periods: pre-, during, and post-ACA. Data within posts were coded as to the linguistic moves being made. Three frequent categories of linguistic function in the data were identified: experience-sharing, advice-requesting and offering, and rationale-offering (N = 1268). These linguistic moves were sub-divided into further categories (e.g., under advice requesting, a request for diagnosis), and a discourse-analytical perspective provides insight into the values indexed in each. Before ACA, forum participants cited access, fear, and a history of unhelpful medical visits as obstacles to seeking care. After implementation, obstacles cited were prior unhelpful visits, followed by access, and uncertainty regarding care-seeking appropriateness. While ACA implementation reduced lack of insurance as an obstacle to obtaining healthcare, online forums indicate that patients continue to find doctors' visits unhelpful, instead choosing to seek medical advice from the lay public. Patients' distrust of the medical profession persisted following ACA implementation. There is a need for public health initiatives to improve this relationship in order to augment health care outcomes.
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williams2019womenspreventive Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Williams, Serena A P;Dhillon, Soneet;
Journal Preventive medicine
Year 2019
DOI
S0091-7435(19)30146-X
URL
Keywords
reproductive health communication women's health policy discourse analysis patient protection and affordable care act linguistics discourse discussion boards health forums

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